冠状动脉内支架在治疗急性心肌梗塞中的作用(摘要)
作者：乔树宾 高润霖 陈纪林 杨跃进 姚民 秦学文 徐波 刘海波 吴永健 姚康宝
单位：北京市，中国医学科学院 中国协和医科大学 心血管病研究所；阜外心血管病医院 冠心病研究室(100037)
关键词：
中国循环杂志99zk44
目的：研究急性心肌梗塞治疗中，冠状动脉内支架应用的效果。
方法：回顾性分析了本院应用经皮冠状动脉腔内成形术(PTCA)和支架置入术治疗30例急性心肌梗塞的情况。
结果：30例患者中，男性26例，女性4例，平均年龄为60.0±10.3岁。3例为心源性休克，27例为killip分级Ⅰ级和Ⅱ级。15例患者为直接PTCA和支架治疗，另15例患者为溶栓失败行挽救性PTCA和支架治疗。梗塞相关动脉为前降支15例，右冠状动脉13例，回旋支2例。共置入38个支架，其中18例患者为选择性置入支架(DeNovo),9例由于球囊扩张结果不满意置入，11例系紧急状态下置入(Bail-out)。28例患者置入支架后成功[<30%残余狭窄，心肌梗塞溶栓治疗临床试验(TIMI)血流为2或3级]，术后造影成功率为93.3%。院内并发症包括：2例患者死于顽固性休克。术中出现室性心动过速、心室颤动3例及支架内血栓形成3例，4例出现低血压。无患者需要急诊冠状动脉旁路移植手术。因此，本组患者的手术成功率为90.0%(27/30)。住院期间，无其它重要并发症发生。
, http://www.100md.com
结论：本组小样本研究表明应用急性心肌梗塞冠状动脉内支架治疗成功率高，发生并发症较少。
Intracoronary Stenting in Treatment of Acute Myocardial Infarction (Abstract)
Division of Coronary Heart Disease, Cardiovascular Institute and Fu Wai Hospital, CAMS and PUMC, Beijing (100037)
Qiao Shubin, Gao Runlin, Chen Jilin, et al.
Objective: To study the role of intracoronary (IC) stenting in the treatment of patients with acute myocardial infarction (AMI).
, 百拇医药
Methods: Retrospective case reviews were used. Thirty patients were treated by PTCA and IC stenting during AMI in our Institute.
Results: There were 30 patients, 26 men and 4 women, mean age 60.0±10.3 years. Three patients were in cardiogenic shock at admission, 27 in Killip′s class Ⅰ and Ⅱ. Direct angioplasty and stenting were performed for 15 patients, rescue angioplasty and stenting for the remaining patients. The infarct-related artery was left descending in 15, right coronary artery in 13, left circumflex in 2. Thirty eight stents were implanted, 9 with suboptimal results, 11 with bail-out. Angiographic success (<30% residual stenosis, TIMI flow Ⅱ or Ⅲ) was achieved in 28 patients (93.3%) after procedure. Inhospital events: 2 patients died from refractory cardiogenic shock, no-reflow in one patient, VF in 3 patients, in-stent thrombosis in 3 patients, low blood pressure in 4 patients (Intra-aortic balloon pump was used in 3 patients). No patient required emergency coronary artery bypass graft surgery. So procedural success rate was 90.0% (27/30). There were no other major complications during hospital course.
Conclusion: Results of our study in a small AMI population demonstrated that intracoronary stenting when used in treatment of AMI was of high success rate and lower complications., 百拇医药
单位：北京市，中国医学科学院 中国协和医科大学 心血管病研究所；阜外心血管病医院 冠心病研究室(100037)
关键词：
中国循环杂志99zk44
目的：研究急性心肌梗塞治疗中，冠状动脉内支架应用的效果。
方法：回顾性分析了本院应用经皮冠状动脉腔内成形术(PTCA)和支架置入术治疗30例急性心肌梗塞的情况。
结果：30例患者中，男性26例，女性4例，平均年龄为60.0±10.3岁。3例为心源性休克，27例为killip分级Ⅰ级和Ⅱ级。15例患者为直接PTCA和支架治疗，另15例患者为溶栓失败行挽救性PTCA和支架治疗。梗塞相关动脉为前降支15例，右冠状动脉13例，回旋支2例。共置入38个支架，其中18例患者为选择性置入支架(DeNovo),9例由于球囊扩张结果不满意置入，11例系紧急状态下置入(Bail-out)。28例患者置入支架后成功[<30%残余狭窄，心肌梗塞溶栓治疗临床试验(TIMI)血流为2或3级]，术后造影成功率为93.3%。院内并发症包括：2例患者死于顽固性休克。术中出现室性心动过速、心室颤动3例及支架内血栓形成3例，4例出现低血压。无患者需要急诊冠状动脉旁路移植手术。因此，本组患者的手术成功率为90.0%(27/30)。住院期间，无其它重要并发症发生。
, http://www.100md.com
结论：本组小样本研究表明应用急性心肌梗塞冠状动脉内支架治疗成功率高，发生并发症较少。
Intracoronary Stenting in Treatment of Acute Myocardial Infarction (Abstract)
Division of Coronary Heart Disease, Cardiovascular Institute and Fu Wai Hospital, CAMS and PUMC, Beijing (100037)
Qiao Shubin, Gao Runlin, Chen Jilin, et al.
Objective: To study the role of intracoronary (IC) stenting in the treatment of patients with acute myocardial infarction (AMI).
, 百拇医药
Methods: Retrospective case reviews were used. Thirty patients were treated by PTCA and IC stenting during AMI in our Institute.
Results: There were 30 patients, 26 men and 4 women, mean age 60.0±10.3 years. Three patients were in cardiogenic shock at admission, 27 in Killip′s class Ⅰ and Ⅱ. Direct angioplasty and stenting were performed for 15 patients, rescue angioplasty and stenting for the remaining patients. The infarct-related artery was left descending in 15, right coronary artery in 13, left circumflex in 2. Thirty eight stents were implanted, 9 with suboptimal results, 11 with bail-out. Angiographic success (<30% residual stenosis, TIMI flow Ⅱ or Ⅲ) was achieved in 28 patients (93.3%) after procedure. Inhospital events: 2 patients died from refractory cardiogenic shock, no-reflow in one patient, VF in 3 patients, in-stent thrombosis in 3 patients, low blood pressure in 4 patients (Intra-aortic balloon pump was used in 3 patients). No patient required emergency coronary artery bypass graft surgery. So procedural success rate was 90.0% (27/30). There were no other major complications during hospital course.
Conclusion: Results of our study in a small AMI population demonstrated that intracoronary stenting when used in treatment of AMI was of high success rate and lower complications., 百拇医药